Insurance Company Foot Dragging

I caught this Op-Ed by Cathy Seipp in the LA Times (hat tip instapundit), and thought I should pass it along. It deals with the problems she is facing getting Blue Cross to pay for her cancer treatments. It seems a fair treatment of the subject from someone who probably had to try very hard to be fair.

I loved the book The Rainmaker, but wasn't in the medical business when I read it. Only now do I understand how real the story is. Insurance companies, no doubt in my mind, try their best to get you to give up on getting a claim paid. They believe, correctly I'm sure, that most people will not fight through all of their layers of bureaucracy to get their money. It's just not worth it to them.

My company currently has a claim with Blue Cross that was first filed on September 30, 2005. That was almost 7 months ago. It is for $625, so it is not a huge amount of money. The widow of our former patient gave up and sent me a check in December since Blue Cross kept sending her notices when they found another reason to deny the claim. She felt guilty that we were not getting paid after all that we had done. Unfortunately for Blue Cross, I don't give up that easily.

I am still fighting, still filling out their forms, and one day will refund the widow her $625 because the insurance company paid the claim. Is the time and effort that I have poured into this worth $625. Not a chance. I've spent more time on hold, filled out more forms, and been transferred to more people than I would want to count. It is a matter of principle for me. The insurance company said they would pay. They are responsible for payment. They don't even dispute that. They just want to wear me down. It won't happen.

This is a real problem for providers of medical care in the United States. I know of at least one doctor who pays his biller 10% of whatever they can get from insurance companies. That means that rates are increased by 10% just to fight the insurance bureaucracy. That's crazy. It isn't good for providers, patients, or the system. Something must change. I guess I'm trying to change it $625 at a time.